Kirata
Posts: 15477
Joined: 2/11/2006
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~ FR ~
With regard to the JAMA citation from the Salon article, Fetal Pain: A Systematic Multidisciplinary Review of the Evidence, the following testimony was given before a U.S. House subcommitte in 2005 following the study's publication.
The speaker is Rhodes Scholar Dr. Sunny Anand, Director, Pain Neurobiology Laboratory, Arkansas Children's Hospital Research Institute; Professor of Pediatrics, Anesthesiology, Pharmacology, and Neurobiology, University of Arkansas College of Medicine:
First of all, they present pain as a hard-wired system, whereby pain impulses are conducted from receptors through nerves and nerve pathways until so-called perception occurs in the sensory cortex. This is an incorrect view of pain, which is rather outdated.
For the last 40 years, medical research has shown, beginning from the gate control theory of pain, that pain reception occurs within a multilayered system with numerous elements of nerve fibers and cells, the functions and the characteristics of which will change depending on the type of pain, the context in which it occurs, as well as other cognitive and behavioral demands at that time, so that the processing of pain and indeed perception of pain doesn't simply occur in the sensory cortex. It can occur at various different levels within the nervous system.
Second, Lee and colleagues presume that the structures used for pain perception in adults are the very same structures used during fetal and neonatal life. The lack of development of these structures is then taken as proof that the fetus does not - or the preterm neonate - would not feel pain until 29 to 30 weeks period of gestation. This is again a flawed line of reasoning.
Many years of careful research in which I have participated has shown that the neonate, or the fetus, is not a little adult; that the mechanisms and structures used for pain processing are very different at different stages of development. Indeed the nervous system will use the elements available at that time, at a particular stage of development, to transduce external and internal stimuli, and pain is an inherent, innate part of this system...
Lastly, I would like to identify that there was ambiguous methodology followed in this review whereby 2,100 articles were obtained from PubMed through a detailed search strategy. And the subsequent disconnect of selecting what evidence to include in the data synthesis did not follow the methods of a systematic review. If I were to review this systematic review, it cannot be replicated, and therefore it calls into question the scientific validity of this approach.
In addition, Dr. Anand comments...
I beg to differ with the contention that the perception of pain occurs only in the sensory or the somatosensory cortex. For example, in conscious adults, if you stimulate the sensory cortex, or if you cut it out completely, it will not alter pain perception. Stimulation does not produce pain perception; removing the sensory cortex does not block pain perception.
So if the viability of the sensory cortex is not a necessary criterion for pain perception in adults, why should that be a criterion for fetus and preterm infants and neonates?
Source
K.
< Message edited by Kirata -- 8/9/2013 7:24:23 PM >
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RE: End of discussion. "Fetal Pain Is A Lie..." - 
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